I dread writing on such a personal topic, but when I was in despair over my condition, I wish I had run across a story like mine. So I break the silence. I’ve discovered over the past year that a staggering number of women suffer from sexual pain after pregnancy and childbirth.

Maybe you’re one of them.

I’m here to say that there is hope. I’m 14 months postpartum and have been fully recovered for months–and my pain was extreme.

If you haven’t had a baby yet, sit up and pay attention. Don’t get scared, just get informed. I learned along this recovery path that many factors pre-pregnancy set me up for this problem. In other words, you can do prevention work. You can also care for yourself postpartum differently than I did.

And if you will never have a baby (perhaps because you’re male) or you had a baby with zero difficulties, just keep in mind that the new mothers around you might be suffering in ways they can’t tell you. If they do tell you, I hope you’ll pass on this information.

Ready to dive in to my (very) personal life? It’s a long story, but I’ll try to make it a little fun along the way.

The Fabulous Birth

Photo by Justice Diven

I birthed our beautiful son, my first, at home with a midwife and doula. It was peaceful, quiet, and amazing. A couple years’ regular meditation practice, plus a birth pool and techniques from a HypnoBabies class, helped me deeply relax and progress quickly and easily.

Because of some concern about the baby’s heart rate at the end, I pushed him out quickly on a birthing stool (deep squatting position) and earned myself a second degree tear. I was disappointed about the tear but glad the baby was safe (with an Apgar of 9 at both readings) and overjoyed by his arrival and the amazing feat I’d just accomplished.

The midwife carefully sewed me up, and we went on our merry way. Well, not exactly. If you’ve had a damaged perineum, you know that the first couple of weeks are no joke. Overall, though, everything seemed normal, and I was in love with my son.

Photo by Justice Diven

The Uh-Oh

At my six week check up, my perineum was extremely sensitive and painful, and the scar looked a bit red and irritated. The midwife suggested I wait a couple more weeks before attempting intercourse. Darn it! But we did, and then we followed every precaution for relaxation, lubrication, and arousal. Yet the pain was excruciating. Excruciating. We waited a week and tried again. Repeat. Repeat. I’m going to get technical here. Mere insertion was excruciating. Actual intercourse was truly impossible.

What the Midwife Said

The midwife said that this was absolutely not normal and referred me to an OB-GYN to get checked out. While tearing is undesirable, it is common* and very rarely causes this problem, though she had heard of other women who had severe intercourse pain after having babies. The stories were scary. She also expressed concern that perhaps she had sewn me up too tightly. I certainly felt “too small,” and she was open to the possibility that she may have contributed to this outcome. (Stay tuned, the story takes a twist later.)

*Note: “common” does not equal biologically normal. We’ll get to that later.

The Meltdown

By this point, I was panicking. The birth itself had been the opposite of traumatic–it was downright empowering–but this aftermath flattened me. I felt powerless. I had done everything right, had a fantastic birth, and still got this outcome. What would happen to my marriage? Would I ever have another baby? (seeing as getting pregnant wasn’t going to happen) I realized I’d have to start talking to people about the problem, and it was beyond mortifying.

I once knew a young woman who had been able to consummate her marriage only a handful of times due to severe pain. I remember thinking at the time that I could not understand why she didn’t get help. Now I do. It is really, really hard to talk about sexual pain–or any kind of very private pain, I would guess. There are shame, humiliation, fear, and all kinds of self-hate involved. Whatever trauma and hurt pride we’re already holding within us gets channeled into this issue, and man, it’s a killer.

What the OB-GYN Said

I’m now at 3 months postpartum. He first expressed unhappiness with the way I was sewn up, saying that he would have used a V shape, rather than a U shape at the back of the vaginal opening. (Again, stay tuned for more about this.) He said the real cause of my pain, however, was that a nerve must have gotten caught up in the stitches and, thus, now the scar. He said that this happens sometimes to the best of birth professionals and that the only solution was reconstructive surgery.

But just in case, he gave me a steroid cream to rule out the possibility that he was wrong. It could merely be inflammation. I asked him if there were any possible side effects, and he said no. I know better than that, having had some experience with steroids before, but for short-term use, I decided to try it. My body is hyper-inflammatory, and it made sense that breaking the inflammation cycle could help it heal itself. Within 3 days I was in round-the-clock pain from the irritation. Thanks, doctor. I called him and he said, “I’m so sorry, that happens sometimes.”

??!!??

Double thanks.

I went in for my follow-up and he confirmed that I would have to have surgery. He also told me that I would likely tear again with the next birth in the exact same place, though I was unlikely to have this same pain problem again because the odds of another nerve getting caught up in the scar were negligible. I said, “What about physical therapy? I’ve heard about that somewhere.” He assured me that pelvic floor PT wouldn’t help me. “No,” I insisted, “I’ve heard of internal physical therapy.” He was skeptical.

I asked him what his success rates for this surgery were. That seemed to surprise him. He thought about it. “It depends on what you mean by success,” he answered. Ah, just what I wanted to hear.

I barely made it to my car before crying my heart out. Then I got smart and used the Tapas Acupressure Technique to calm down. The TAT is the only reason I was able to drive home safely. It also helped me learn where some of my intense fear and feelings of trauma were coming from (e.g., not from the facts of the situation but from places within me than needed healing and, yes, some correcting. I was still in the information-gathering stage, but had already jumped to extreme conclusions about the long miserable life ahead of me and how I’d been abandoned by God. What a waste of energy!)

What the Massage Therapist Said

I learned about a massage therapist in our area who specializes in postpartum scar recovery, whether from vaginal or cesarean birth. I went to her to get a totally different kind of opinion. I cried within the first 5 minutes. She was very compassionate and said she’d helped other women in some similar situations, but none with such severe pain from such small provocation. She encouraged daily massage of the scarred area with castor oil and suggested I use a vibrator to help break up the scar tissue. (Note: these turned out to be excellent tips, even though they weren’t the whole story for me.)

A Love Song to Katy Bowman

Here’s where things really start looking up. I had been reading this biomechanics blog called Katy Says off and on for over a year. In fact, following Katy’s advice about untucking my pelvis nearly instantly reversed the sneeze pee I’d begun to experience in the second trimester of pregnancy–sneeze pee that never returned, mind you. Let me tell you, that was compelling!

The End of Sneeze Pee was a great gift, sure, but it gets better. In fact, I think Katy more than deserves a song. As a poet herself, I think she’d particularly appreciate it.

Oh, Katy Bowman,
You’re a fabulous woman
Whose praises I’ll sing from the hills.
The healing I’ve found
Would really astound
Those men in white coats and their pills.

And their knives.
(Surprise, surprise.)

Your blog gave me direction
When I had an objection
To what seemed to me foul play.
For another way I prayed
To heal a body betrayed,
And you helped me find it–hooray!

Katy, you see, had written once (hilariously) about internal physical therapy, and it was re-finding that blog post that got me on my way. My doctor could scoff, but now I knew that there were people out there who did exactly the kind of work that might–just might–help me without surgery. Her blog played an instrumental role later in my recovery too, but I’ll stop there for tonight.

Stay tuned for Part 2 tomorrow. Teaser: Notice how so far everyone, including me, has focused on the tearing and the sewing up and the scar as the primary problem? That’s about to change.

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